Purpose

Many techniques were used for the treatment of hydrocephalus, and ventriculoperitoneal shunt surgery is a widely used procedure. Ventriculoperitoneal shunt surgery has been associated with several complications like obstruction of the tube, infection, cerebrospinal fluid loculation, intestinal obstruction, migration of the shunt, and perforation of the intestinal organs. Perforation of the bowel owing to protrusion of ventriculoperitoneal shunt catheter from the anus is an extremely rare complication. Mini or exploratory laparotomy and revision of peritoneal part of shunt and repair of bowel perforation, or pulling out the ventriculoperitoneal shunt catheter and using external ventricular drainage and antibiotics, or colonoscopic removal of ventriculoperitoneal shunt catheter and repair of the bowel can be performed. Retrograde contamination of cerebrospinal fluid and meningitis is a very important part of the treatment in these cases. We aimed to present two cases with bowel perforation who treated with endoscopically.

Methods

We report the cases of 2 patients with transanal protrusion of VPS catheter and the management via endoscopic therapeutic options.

Results

Successful treatment of the patients was achieved by endoscopic removal of the catheter and endoscopic repair of the bowel perforation.

Conclusion

If peritonitis, bowel obstruction, or abscess does not occur, endoscopic removal of shunt and bowel repairing with endoclips may be enough.

中文翻译：

---

脑室腹腔分流导管肠穿孔：内镜下治疗2例。

目的

许多技术被用于治疗脑积水，脑室腹腔分流术是一种广泛使用的手术。脑室腹腔分流手术与多种并发症有关，如管梗阻、感染、脑脊液闭塞、肠梗阻、分流管迁移和肠器官穿孔。由于脑室腹腔分流导管从肛门突出而导致的肠穿孔是一种极为罕见的并发症。可进行微创或探查性剖腹手术及腹腔分流修复及肠穿孔修复，或拔除脑室腹腔分流导管并使用脑室外引流及抗生素，或结肠镜下取出脑室腹腔分流导管并修复肠道。在这些病例中，脑脊液和脑膜炎的逆行污染是治疗的一个非常重要的部分。我们的目的是介绍两例经内镜治疗的肠穿孔病例。

方法

我们报告了 2 例 VPS 导管经肛门突出患者的病例以及通过内镜治疗方案进行的管理。

结果

通过内镜下拔除导管和内镜下修复肠穿孔实现了患者的成功治疗。

结论

如果没有发生腹膜炎、肠梗阻或脓肿，则内镜下切除分流管并用内夹进行肠道修复可能就足够了。